MSM Who Use Mobile Apps for Sex More Likely to Have STIs

According to a study published in BMC Public Health, men who have sex with men who seek out sexual partners on smartphone apps are more likely to have sexually-transmitted infections—including syphilis, gonorrhea, and chlamydia—than those who do not use these apps. Mobile platforms dedicated to HIV prevention may help reduce this likelihood, the study’s investigators suggest.

“The prevalence of men who have sex with men-related HIV infection is increasing worldwide. Advances in communication technology now offer men who have sex with men different opportunities to meet sexual partners,” the investigators, led by Haidong Wang, MD, of the North China University of Science and Technology, wrote. “With the proliferation of apps, increased use of these apps may facilitate finding casual sexual partners, resulting in unsafe sexual practices. Prior work has shown that men who have sex with men who use these apps (app-users) tend to have more sexual encounters, more frequent anal intercourse, more unprotected sex, and a larger number of sexual partners known to have HIV and other sexually-transmitted infections …[yet] some studies suggested that app-users may be more likely to practice safer sex with these partners than are non-users.”

Investigators from China reviewed relevant studies related to mobile dating and/or sex apps specifically targeting men who have sex with men, selecting articles that focused on app users and non-app users as well as those that reported data for sexual behaviors or sexual health in this population. Data extracted from the 25 selected studies included the date of sexually-transmitted infections (ie, HIV, syphilis, gonorrhea and chlamydia) and sexual behaviors (eg, the number of partners met via apps, HIV testing, unprotected anal/oral sex).

In the pooled analysis of the studies, the self-reported prevalence of an HIV diagnosis prior to app use was between 2.2% and 37.7% (pooled prevalence, 6%; 95% confidence interval [CI], 4%—11%). The lifetime range rates of HIV testing among app users and non-app users was roughly similar (49.1%-96.7% vs 50.1%-97.1%, respectively). Users of apps were more likely to report chlamydia (odds ratio [OR] = 2.22; 95% CI, 1.92–2.56) and gonorrhea (OR = 2.36; 95% CI, 2.07–2.70) in studies that compared these users with non-users. Both app users and non-app users had similar rates of HIV (OR = 0.89, 95% CI, 0.68–1.16) and syphilis (OR = 1.92; 95% CI, 0.91–4.03) diagnoses. Following the omission of 1 study with noticeable heterogeneity, the OR for contract syphilis among app users rose to 3.00 (95% CI, 1.84–4.91).

“Our study was not exceptional for finding that risky sexual behaviors (eg, greater number of sexual partners, unprotected sex) were common among app-users,” the authors wrote. “Apps potentially foster risky behavior because users could carry their smartphones with them at all times.”

A limitation of the meta-analysis was the inclusion of mostly studies that were descriptive and without a suitable comparable group, such as non-app users. Additionally, the study’s investigators indicate that the associations observed between app use and sexual risk behaviors and/or sexually-transmitted infections prevalence can merely be interpreted as correlational rather than causational.

“Taken together, the advancements in apps and the increase in men who have sex with men using these apps may produce more adverse effects on sexual health,” the investigators concluded. “The data demonstrate the need for increased app-based prevention interventions among men who have sex with men. In addition, more studies, especially longitudinal studies, are needed to confirm the relative risk between app-user and non-users.”

Reference:

Wang H, Zhang L, Zhou Y, et al. The use of geosocial networking smartphone applications and the risk of sexually transmitted infections among men who have sex with men: a systematic review and meta-analysis. BMC Public Health. 2018;18(1):1178.